Assessing sexually transmitted infections in a cohort of women living with HIV/AIDS, in Rio de Janeiro, Brazil

Abstract

A cohort of 458 HIV-positive women under antiretroviral therapy has been followed at a reference hospital in Rio de Janeiro, Brazil. Most of them belong to impoverished social strata. Patients were screened for sexually transmitted infections (STIs) and gynaecologic conditions. Some STIs were found to be uncommon (e.g. chlamydial and gonococcal infections), while some conditions (bacterial vaginosis) and STIs, e.g. hepatitis B and human papilloma virus (HPV) infection, were found to be quite prevalent. The latter is of special concern, due to the high prevalence of HIV/HPV co-infection ( approximately 51%) and its association with severe immunodeficiency, in a context of unacceptable high levels of uterine cancer and uneven gynaecological care. HIV-positive women are in need of comprehensive health services, including high-quality, regular, gynaecologic care in order to diagnose and treat lower genital tract infections and prevent the evolution of HPV-related lesions. Reproductive counselling should be a part of this approach.

Anal Human Papillomavirus (HPV) Prevalences and Factors Associated with Abnormal Anal Cytology in HIV-Infected Women in an Urban Cohort from Rio de Janeiro, Brazil

“…Cohort procedures have previously been published. 21 Briefly, participants in the IPEC Women's HIV Cohort ‡ 18 years of age were invited by their gynecologists to participate in the IPEC Women's HIV Anal HPV and Lesions Study. Anal and cervical swab specimens were collected by onsite gynecologists between January, 2011 and August, 2013 for anal and cervical cytology, and anal HPV genotyping.…”

Desempenho do exame citológico e da captura híbrida II no rastreamento de lesões intraepiteliais escamosas de alto grau em mulheres HIV+

“…Esses exames foram realizados de maneira não cega, isto é, os examinadores tinham conhecimento do resultado do exame citológico ao realizarem a colposcopia, sendo ele verdadeiro para o exame histopatológico. Maiores detalhes sobre outros procedimentos e análises epidemiológicas relacionadas à coorte podem ser encontradas na literatura 25,26 .…”

The first ten years: achievements and challenges of the Brazilian program of universal access to HIV/AIDS comprehensive management and care, 1996-2006

“…HPV infection is relatively prevalent in the Brazilian general population 60 , and especially prevalent and aggressive among women living with HIV/AIDS 61,62,63,64,65 . HIV infection may increase the oncogenicity of high-risk HPV types and the activation of low risk types, with higher rates of squamous intraepithelial lesions (SIL), and uterine cancer, over time 63,66 .…”

“…On the other hand, other malignancies, especially malignant lymphoma and cervical cancer, have been increasingly important causes of morbidity and mortality in AIDS patients as patients live longer 65,73,74 .…”